Healthy Skin Expert Dermatology Advice

Scar Tactics: Scar Reduction and Prevention Secrets

From silver to Vitamin C, find out how to keep a scar from forming. Already marked? There’s hope for you too.

When it comes to scars, your body is like a historical map, each bump and depression a memento of past accidents and adventures. Some of these marks may instill pride (“That one’s from the time I went mountaineering in Morocco. Must have fallen 20 feet before landing on the ledge!”). Others, you’d probably prefer to forget, like the remnants of your adolescent struggle with acne, or the unsightly souvenir of the first, and, last time you tried longboarding. But there are ways you can change the topography of your skin.

A recent survey of Canadian women found more than 90 percent had at least one scar somewhere on their bodies. Although most were bothered by these blemishes, few knew about their options for treatment. Dr. Lisa Kellett, a cosmetic laser dermatologist in Toronto, says while a third of her patients come in specifically for scars, the majority are seeking treatment for something else and just happen to mention a scar on the side. They usually assume nothing can be done for them. “It’s true that once you have a scar, you can never get rid of it,” Kellett says. “But with treatment you can make it flatter, less red and closer to your normal skin colour and texture.” One of the most important things is to keep a scar from forming in the first place,” she says.

Healing hints: Scars are a natural part of healing and form when your skin repairs itself after an accident, surgery or illness. The greater the damage, the longer it takes to heal and the more likely you will be left with a noticeable scar. Your chances of scarring also increase depending on the location of the wound, says Kellett. “Head and neck wounds usually heal better because there are more arteries there than in your legs, so there’s a better vascular supply.” Areas with a kit of movement and tension in the skin, such as your knees, are more likely to scar, as are dirty wounds or those that become infected.

Some people are just genetically better healers than others, or may have stronger immune systems, Kellett says. Even what you eat can make a difference. “If your diet is poor, you may be more susceptible to scarring because your body doesn’t have the vitamins and minerals it needs to heal properly,” she says.

You should eat a balanced diet with lots of fruits and vegetables and get enough vitamin C to promote healing. Smoking, and even being exposed to secondhand smoke, can affect your healing powers. A university of California study found secondhand smoke reduces the ability of new cells to get to a wound site, causing slower healing and more scarring.

From Glow Magazine July/August 2005 text by Sydney Loney.  To read the entire article please click here

No Need to Let Scars Mar

 For the most part, there are no dark secrets lurking within. It’s what’s on the surface that troubles them the most: scars. The saying might be that a person is “scarred for life,” but Kellett says that’s not entirely true. There are options few people are aware of.

If appropriate, she recommends patients start with the least expensive option – coverup creams. They’re more effective than in the past, and, for many, it does the trick.

If that doesn’t work, there are silicone sheets on the market that might. When applied to a scar, the technology mimics the natural barrier function of healthy skin and hydrates it to diminish the scar’s appearance and size.

Steroid injections are a common treatment but must be administered by a physician and start at $50. Laser treatment, which has a starting price of $350, can also be effective. “I usually start with the cheapest and easiest,” Kellett says.

From 24 Hours, July 18, 2005.

Health: You Ask - Scarring

Health: You Ask

What’s up, doc? Our experts give an Rx for your wellness questions.

Q: “Is there anything I can do to prevent a wound from scarring?”

According to Toronto-based dermatologist, Dr. Lisa Kellett, one of the best ways to prevent scarring is to properly care for the wound. Wash your cut with soap and water after the injury has occurred. It’s very important to keep the cut moist to let it heal properly (contrary to the “let it breathe” theory).

Apply some antibiotic cream with a cotton applicator (to make sure you’re not infecting your cut with a dirty finger) and cover the cut with a bandage. Keep it covered for about a week, or until it’s no longer oozing or has started to close. Then, if you’re concerned that you will have a significant scar, apply a product such as Polysporin Scar Solution, a bandage-like strip that uses silicone technology to mimic the skin’s natural barrier function to either prevent a scar from occurring or reduce the appearance of an existing scar.

The two most common types of scars are hypertrophic, where the skin is raised and slightly puffy (this type is more common in people with lighter skin), and keloidal, where the raised, puffy skin goes beyond the perimeter of the original wound (this type is more common in people with dark skin). If the appearance of your scar still hasn’t improved after trying a silicone treatment, see your doctor, who can inject the scar with an anti-inflammatory steroid to help flatten and reduce the scar.

Lastly, if the scar still persists, a doctor can use a laser treatment to remove it. This is a pricey option, as most people need about five treatments, and costs about $350 and up. (And is not covered by provincial health insurance.)

From Flare Magazine, June 2005.

In This Skin: Achieve Flawless Summer Skin with Non-Invasive Treatments

There’s no reason to cover up this summer. The newest body care treatments are non-invasive and will rid your skin of its blemished past.

The skin on our body is a veritable scrapbook of our existence, a time capsule of sorts, containing physical tokens of the past: the scar on your knee you got the first time shaving; the marks on your back from that terrible strain of chicken pox; the web of spider veins on your thigh, a badge you earned from carrying three children to term – hence those stretch marks on your stomach.

Scars: For men, a scar can be a great source of material for a tall tale, usually gang related or involving a shark. But women generally don’t take pride in their imperfections. Fortunately, there are topical treatment options, depending on the kind of scarring. “The two types we worry about are hypertrophic, scars that are raised instead of healing nice and flat; and keloids, scars that are raised as well but grow beyond the original wound,” says Toronto-based cosmetic dermatologist Dr. Lisa Kellett. One option is silicone gel sheets. “Silicone has an anti-inflammatory action; it’s occlusive, and it’s though that the occlusion helps flatten the scars.” For atrophic (depressed) scars, like pockmarks and acne scars, resurfacing lasers like erbium or CO2 lasers are very effective, “because they actually burn off layers of skin to smooth the surface,” says Kellett.

From Fashion Magazine, June 2005 text by Anne Rasminsky.  To read the entire article please click here

The Body Glossary - Scars

Red Carpet Primp and Prep

Scars can make an unsightly impression. They form whenever skin is damaged- whether from a small trauma (a popped pimple), an injury (a fall from skyscraper stilettos) or invasive surgery. In response to the injury, the skin attempts to repair itself by releasing growth factors, which then induce collagen production. The type of scar you get depends on how assiduously your collagen-production plants work. If they’re the lazy sort, you’ll wind up with a skin depression called an atrophic scar. If your collagen factories go into overdrive, collagen will build up at the site of the injury, resulting in a raised red (hypertrophic or keloid) scar.

The trick to treating scars- apart from avoiding heels and developing a fondness for ballet flats- is to control those crazy collagen cells while they’re at work on a developing scar. “You want to optimize the healing process,” says Toronto dermatologist Dr. Lisa Kellett of DLK on Avenue. “Keeping the wound clean, moist and infection-free is key- and above all, no picking, which can increase the scarring.” Once fully formed, scars have limited treatment options, but the development of over-the-counter remedies is an area of keen interest to many dermatologists, so stay tuned.

From Fashion Magazine, June 2006 - text by Liza Finlay.

Scar-free Solutions

New scar treatments can diminish scars- no matter how long you’ve had them.

It used to be that once you had a scar, you were stuck with it- for good. Not anymore. “Once you have a scar, there are simple treatments that you can pick up at your drugstore that can help.” says Dr. Lisa Kellett, a dermatologist in Toronto.

   Scar Prevention - Save your skin from new scars with these four tips from Dr. Lisa Kellett.

1. Keep it moist. “Most people like to let the wound dry out,” says Dr. Kellett, “but you really want to keep the wound surface moist because it will heal better that way.”

2. Don’t pick it. Aggravating the wound will make it heal more slowly and make a scar more likely- and more noticeable.

3. Wait. Wait until the wound is completely healed before beginning a scar treatment- at least four to six weeks- to ward off infection.

4. Keep it covered. Once you have a scar, keep it covered. “protect your scar from everything,” says Dr. Kellett, dirt, cleaning chemicals and sun exposure.

From Elevate Magazine, June 2005, text by Heather Osler.  To read the entire article please click here

It’s a Whiteout: Porcelain Skin Perfection

This summer the big news in beauty is the disappearing act, as everything from moisturizers to bandages are going to new lengths in the pursuit of flawless skin.

Disappearing acts are the rage these days, and I’m not just talking about Jennifer Wilbanks vanishing at the 11th hour of her wedding last month.

Products with names such as White and Blanc Expert may sound more like a Home Depot product to paint your ceiling with than to “brighten” your complexion, but so-called “whitening” cosmetics are making the rounds at department stores.

Then there’s the stretch-mark cream women are using in droves on wrinkles around their eyes and the Band-Aids that come with an anti-scar formula built-in. Even those of us who aren’t obsessed with wrinkles (i.e. under 25 or live in Europe) still covet a “flawless finish.”

“There’s something delicate and precious about skin that looks porcelain,” says Denise Wild, associate beauty editor at Flare magazine. “To me, a pale complexion has a glow that’s youthful and innocent. It doesn’t look beaten up by time or weather.”

The most obviously named of the new products is White – from Kiehl’s, the company whose old-fashioned packaging and detailed product ingredient lists have previously made it seem like a spectator rather than a heavyweight when it comes to beauty trends. The new line includes a cleanser, toner, concentrate and moisturizer that aim to lighten skin.

Critics and senior feminists have long decried products like White for not merely removing physical imperfections, but making these “distinguishing marks” invisible, erasing a hard-won badge of character – individuality – from our faces. Why now, of all times in history, the desire for geisha glam?

“Pale white skin historically and culturally is a sign of beauty and affluence in Asia, particularly Japan, where you have the symbol of the geisha,” says Donna Paty, a national education manager for Kiehl’s. “It was thought that pale skin was a sign that you weren’t out working in the sun.”

“If you don’t have any freckles or sun damage, it will brighten the skin. It won’t make it white, but it will even pigmentation,” Paty says. “Make it look clearer, brighter and more radiant.” And yes, non-Asians can smear and rub to their hearts content if they are unhappy with their complexion’s unevenness. Despite the word “whitening,” there is no bleach – which should alleviate fears of a Michael Jackson-type result.

For spring 2005, several fashion designers, including Chanel, sent models down the runways with China-doll pale faces. But as for the great white way being the latest tricke-down trend from the catwalk, not so fast, Wild says.

“On the runways, we see a range of complexions all the way from sun-kissed to milky white,” she says. “Each woman has a beauty and complexion ideal that’s sexy to them. Most women are looking to enhance and perfect what they’ve got, so I think the Asian market has been devoted to lightening and brightening products for so long because their complexions are naturally close to pale, whereas for example Latinas usually strive for the perfect Ocean Drive/Turtle Island beached bronze.”

While nobody is promising perfection, you can go pretty far sans scalpel with a little squeeze of a tube or a strip of silicone. Dr. Lisa Kellett, a Toronto-based cosmetic dermatologist, says that while the No. 1 complaint she hears from women is “I look tired,” 30 per cent of her patients come to her for scar treatment.

“A lot of people don’t know that they can do something about their scars,” she says. “When I see someone wearing a turtleneck in July, I know they’re hiding a scar so I ask them about it.”

She treats patients from the Hospital for Sick Children (for free), as well as cosmetics-enhancement seekers, with laser and other light-source equipment as well as silicone pads.

“The technology in the last six years has really made scar removal possible,” she says. Over-the-counter silicone pads such as Polysporin Scar Solution and Elastoplast Scar Therapy can be cut to fit the size and shape of a scar, and are worn like Band-aids for 12-hour periods until a scar is gone.

From The Globe and Mail, May 21, 2005, text by Kim Izzo.  To read the entire article please click here

No need to let scars mar

Treatments can lessen the effects

Many of Dr. Lisa Kellett’s patients have something to hide

For the most part, there are no dark secrets lurking within. It’s what’s on the surface that troubles them the most: scars.

Kellett has patients who try to hide them with long-sleeved shirts. Others wear turtleneck sweaters in July. More consistently style their hair to cover one side of their face.

“For people who have scars, it can be very debilitating,” says the Toronto-based dermatologist.

“No one talks about scars and I see a lot of people who really don’t like their scars. People are very self-conscious.” The saying might be that a person is “scarred for life,” but Kellett says that’s not entirely true. There are options few people are aware of.

“Once you have a scare it will never fully go away but there are a heck of a lot of things now that we can do to help make it look better,” Kellett says. “It’s not like you treat it and it’s gone completely. But you can make it less red or flatter. You can make it blend in with surrounding skin a little better. That would be a reasonable expectation.”

If appropriate, she recommends patients start with the least expensive option - coverup creams. They’re more effective than in the past and, for many, it does the trick.

Silicone Sheets If that doesn’t work there are silicone sheets on the market that might. When applied to a scar, the technology mimics the natural barrier function of healthy skin and hydrates it to diminish the scar’s appearance and size. Raised scars can become flatter, smoother, while red, discoloured scar tissue can fade to a more natural skin tone.

Steroid injections are a common treatment but must be administered by a physician and start at $50. Laser treatment, which has a starting price of $350, can also be effective.

“I usually start with the cheapest and easiest,” Kellett says. No matter what route a patient goes, she says the newer the scar, the easier it is to treat.

“I like to see a scar that’s red, because I have a lot more treatment options. If I see a scar that’s 25 years old, can I make it better? Yes. But not as much improvement with a newer scar.

From the Ottawa Sun, May 2005.

Scarred, But Not For Life

We aren’t all as comfortable with our imperfections as Britney Spears, whose recent commando stance put her C-section scar on full display.  Instead, you probably wish your acne scars, childhood traumas and reminders of surgeries-gone-by would just fade into oblivion.  While you can’t magically erase those troubling tracks, says Toronto-based dermatologist Dr. Lisa Kellett, new treatments can improve scarring by as much as 95 per cent.  So bring on bikini season.

For more information on Dr. Kellett or her Toronto clinic, DLK on Avenue please click here

From Chatelaine, April 2007 - text by Barb Gormley.